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The Correlation Between Obesity-Related Diseases and Non-alcoholic Fatty Liver Disease in Women in the Pre-operative Evaluation for Bariatric Surgery Assessed by Transient Hepatic Elastography

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Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) is a common, severe disease in obese patients. However, NAFLD is usually underestimated by ultrasonography. Liver biopsy is not routinely done in bariatric surgery or during the follow-up. This study therefore examined the correlation between metabolic syndrome and NAFLD in morbidly obese patients based on an assessment using transient hepatic elastography (THE).

Material and Methods

This study involved 50 female patients in the pre-operative phase for bariatric surgery. Before surgery, we collected clinical, laboratory, and anthropometric variables. THE measurements were obtained using a FibroScan® device (Echosens, Paris, France), and steatosis was quantified using Controlled Attenuation Parameter software (CAP). Statistical analyses were done using linear correlation and the Kruskal-Wallis test.

Results

The mean of THE and CAP values were 7.56 ± 4.78 kPa and 279.94 ± 45.69 dB/m, respectively, and there was a significant linear correlation between the two measurements (r = 0.651; p < 0.001). The numbers of metabolic syndrome parameters did not influence the THE (p = 0.436) or CAP (p = 0.422) values. HbA1c and HOMA-IR showed a strong linear correlation with CAP (r = 0.643, p = 0.013 and r = 0.668, p = 0.009, respectively) and a tendency to some linear correlation with THE (r = 0.500, p = 0.05 and r = 0.500, p = 0.002, respectively).

Conclusion

Morbidly obese women submitted to FibroScan® presented a high prevalence of severe steatosis and advanced fibrosis in our sample. Insulin resistance parameters were correlated with steatosis, but less with fibrosis.

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Author information

Authors and Affiliations

  1. FIOCRUZ / Andarai Federal Hospital, Rio de Janeiro, RJ, Brazil

    Fernando de Barros

  2. Postgraduate Program, Fluminense Federal University, Niterói, RJ, Brazil

    Fernando de Barros

  3. Postgraduate Program in Medical Sciences, Fluminense Federal University, Niterói, RJ, Brazil

    Sérgio Setúbal

  4. Department of General Surgery, Fluminense Federal University, Niterói, RJ, Brazil

    José Manoel Martinho

  5. Internal Medicine Division, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil

    Nathalie Carvalho Leite

  6. Department of Gastroenterology, Fluminense Federal University, Niteroi, RJ, Brazil

    Thais Guaraná

  7. Department of Statistics, Fluminense Federal University, Niterói, RJ, Brazil

    Ana Beatriz Soares Monteiro

  8. School of Medicine, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil

    Cristiane A Villela-Nogueira

  9. 118 João Lira St, Apt 102, Leblon, Rio de Janeiro, 22430-210, RJ, Brazil

    Fernando de Barros

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  1. Fernando de Barros
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Correspondence to Fernando de Barros.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

The Ethics and Research Committee of the Fluminense Federal University, Niteroi, Brazil, approved this study (protocol no. 363.683). The ClinicalTrials.gov identifier is NCT02394353 (Ministry of Health, Brazil).

Conflict of Interest

The authors declare that they have no competing interests.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

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de Barros, F., Setúbal, S., Martinho, J.M. et al. The Correlation Between Obesity-Related Diseases and Non-alcoholic Fatty Liver Disease in Women in the Pre-operative Evaluation for Bariatric Surgery Assessed by Transient Hepatic Elastography. OBES SURG 26, 2089–2097 (2016). https://doi.org/10.1007/s11695-016-2054-y

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